BACKGROUND: Cytomegalovirus (CMV) infection remains as an important cause of morbidity and mortality in children undergoing hematopoietic stem cell transplantation (HSCT). Our aim was to assess the incidence, risk factors, and outcome related to CMV infection in children after HSCT in a developing country. METHODS: From October 1, 1999, to December 31, 2005, we prospectively studied all patients admitted to the HSCT unit at Hospital Luis Calvo Mackenna in Santiago, Chile. Serologic studies before transplantation and weekly CMV infection surveillance (antigenemia or quantitative PCR) were routinely obtained. Patients with positive antigenemia or quantitative PCR received pre-emptive therapy with ganciclovir, and cases of unfavorable clinical evolution, persistent positive antigenemia, or quantitative PCR after 14 days of ganciclovir were treated with foscarnet. RESULTS: Ninety-seven patients received HSCT. Their median age was 8 years (range, 3 months to 24 years) and their overall survival was 67%. CMV reactivation was diagnosed in 26 patients. Of these, three developed CMV disease (two interstitial pneumonia, one hemorrhagic cystitis). One of the patients with pneumonia died. Risk factors identified were pre-transplant serologic status (positive recipient), acute and chronic graft versus host disease (GvHD), GvHD prophylaxis, and treatment with antithymocyte globulin. CONCLUSIONS: The rate and prognosis of CMV infection among children treated at our HSCT unit is similar to those reported from industrialized countries. These findings reflect adequate prevention and management of CMV infection within our program. (c) 2009 Wiley-Liss, Inc.
BACKGROUND:Cytomegalovirus (CMV) infection remains as an important cause of morbidity and mortality in children undergoing hematopoietic stem cell transplantation (HSCT). Our aim was to assess the incidence, risk factors, and outcome related to CMV infection in children after HSCT in a developing country. METHODS: From October 1, 1999, to December 31, 2005, we prospectively studied all patients admitted to the HSCT unit at Hospital Luis Calvo Mackenna in Santiago, Chile. Serologic studies before transplantation and weekly CMV infection surveillance (antigenemia or quantitative PCR) were routinely obtained. Patients with positive antigenemia or quantitative PCR received pre-emptive therapy with ganciclovir, and cases of unfavorable clinical evolution, persistent positive antigenemia, or quantitative PCR after 14 days of ganciclovir were treated with foscarnet. RESULTS: Ninety-seven patients received HSCT. Their median age was 8 years (range, 3 months to 24 years) and their overall survival was 67%. CMV reactivation was diagnosed in 26 patients. Of these, three developed CMV disease (two interstitial pneumonia, one hemorrhagic cystitis). One of the patients with pneumonia died. Risk factors identified were pre-transplant serologic status (positive recipient), acute and chronic graft versus host disease (GvHD), GvHD prophylaxis, and treatment with antithymocyte globulin. CONCLUSIONS: The rate and prognosis of CMV infection among children treated at our HSCT unit is similar to those reported from industrialized countries. These findings reflect adequate prevention and management of CMV infection within our program. (c) 2009 Wiley-Liss, Inc.
Authors: Raphael Carapito; Ismail Aouadi; Angélique Pichot; Perrine Spinnhirny; Aurore Morlon; Irina Kotova; Cécile Macquin; Véronique Rolli; Anne Cesbron; Katia Gagne; Machteld Oudshoorn; Bronno van der Holt; Myriam Labalette; Eric Spierings; Christophe Picard; Pascale Loiseau; Ryad Tamouza; Antoine Toubert; Anne Parissiadis; Valérie Dubois; Catherine Paillard; Myriam Maumy-Bertrand; Frédéric Bertrand; Peter A von dem Borne; Jürgen H E Kuball; Mauricette Michallet; Bruno Lioure; Régis Peffault de Latour; Didier Blaise; Jan J Cornelissen; Ibrahim Yakoub-Agha; Frans Claas; Philippe Moreau; Dominique Charron; Mohamad Mohty; Yasuo Morishima; Gérard Socié; Seiamak Bahram Journal: Bone Marrow Transplant Date: 2020-04-14 Impact factor: 5.483